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Evidence-Based Conservative Treatment Strategies for Lumbar Radiculopathy: A Systematic Review.

Aishwarya P Shinde1, Akshaya V Joshi1, Sandeep B Shinde1

  • 1Department of Musculoskeletal Sciences, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.

Cureus
|July 11, 2026
PubMed
Summary

Conservative treatments for lumbar radiculopathy offer short-term pain and function improvements. However, evidence quality is limited by study heterogeneity and methodological issues, requiring cautious interpretation and further research.

Keywords:
conservative managementdegenerationneural tissue mobilizationspine diseasestraight leg raise

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Area of Science:

  • Orthopedics and Rehabilitation Medicine
  • Evidence-Based Practice

Background:

  • Lumbar radiculopathy is a common, debilitating spinal condition causing significant pain and functional impairment.
  • Conservative treatments are first-line management, but their comparative effectiveness is unclear due to literature heterogeneity.

Purpose of the Study:

  • To systematically review and critically appraise evidence on non-surgical, conservative interventions for lumbar radiculopathy.
  • To synthesize findings from randomized controlled trials (RCTs) evaluating various conservative therapies.

Main Methods:

  • Systematic review adhering to PRISMA 2020 guidelines, registered with PROSPERO.
  • Searched multiple databases (PubMed, Scopus, etc.) up to 2026 for RCTs on lumbar radiculopathy.
  • Assessed methodological quality using the Cochrane Risk of Bias 2 (RoB 2) tool; performed narrative synthesis due to heterogeneity.

Main Results:

  • Nineteen RCTs (2016-2026) investigated manual therapy, neural mobilization, exercise, physical modalities, and multimodal regimens.
  • Combined therapies like manual therapy with exercise or neurodynamics showed significant short-term benefits over conventional care.
  • Specific interventions, such as spinal mobilization with leg movement and neural mobilization, demonstrated statistically significant improvements in pain and disability.

Conclusions:

  • Conservative interventions provide measurable short-term improvements in pain and function for lumbar radiculopathy.
  • Evidence certainty is limited by clinical heterogeneity and methodological constraints, precluding meta-analysis.
  • Further high-quality trials with standardized outcomes and adverse event reporting are necessary for definitive conclusions.